Advanced Cardiovascular Life Support (ACLS) Practice Exam

When should synchronized cardioversion be utilized in acute care?

1. Only for patients in shock

2. For stable arrhythmias only

3. For unstable tachyarrhythmias

4. During cardiac arrest

The correct answer is: For unstable tachyarrhythmias

Synchronized cardioversion is specifically indicated for unstable tachyarrhythmias. This includes rhythms such as atrial fibrillation, atrial flutter, or ventricular tachycardia that lead to hemodynamic instability, manifesting as symptoms like hypotension, altered mental status, chest pain, or signs of heart failure. In these situations, the tachyarrhythmia may compromise the patient’s circulation, making immediate intervention necessary to restore a stable heart rhythm and improve blood flow. The synchronization aspect of cardioversion is important because it allows the delivered energy to be timed with the R wave of the ECG, minimizing the risk of inducing ventricular fibrillation. Utilizing synchronized cardioversion in unstable patients can effectively restore normal rhythm and stabilize the individual, as the procedure is designed to quickly and safely correct these dangerous arrhythmias. In contrast, while some arrhythmias are managed through other means, synchronized cardioversion should be avoided in certain situations such as during cardiac arrest, where immediate defibrillation is warranted, or in patients who are stable, as medications are often preferred for those arrhythmias.